Infantile hemangiomas are common benign soft tissue tumors affecting the pediatric population. We present a case report of an 11-year-old girl with vulvar hemangioma accurately diagnosed and effectively managed using low-dose propranolol. The patient was treated with oral propranolol at 0.7 mg/kg/day for three months, with significant clinical improvement and near-complete lesion resolution. The patient showed an excellent response with minimal side effects, emphasizing the significance of thorough clinical evaluation and the success of pharmacological therapy in avoiding surgical or aesthetic interventions, particularly considering the hemangioma's location and the patient’s age.

Raising of mitogenic and anti-apoptotic agents - such as insulin, insulin-like growth factor type 1, and estrogen - during obesity and diabetes mellitus (types 1 and 2) favors the endometrial cancer (EC) development. Metformin, commonly used for treating type 2 diabetes, and resveratrol, a natural polyphenol, can both decrease cancer cell proliferation by modulating the PI3K/Akt/mTOR pathway. We evaluate the effects of metformin and/or resveratrol in an in vitro model of human type 1 endometrioid EC. Ishikawa cells were treated with 0.1 to 50 mM of metformin and/or 0.1 to 75 μM of resveratrol from 24 h to 72 h. Analyses assessed cell viability, cytotoxicity, caspases activation, mitochondrial function, cellular death, cell cycle, and the PI3K/Akt/mTOR pathway gene expression. In-silico analysis was conducted using Cytoscape. Metformin induced mitochondrial swelling, caspase-mediated apoptosis, and cell cycle arrest. Resveratrol decreased mitochondrial mass, cytotoxicity, and induced cell cycle arrest. Combined treatment with the highest concentrations reduced mitochondrial activity, cytotoxicity, and caspase activation while maintaining apoptotic features and cell cycle arrest. Resveratrol attenuated the toxic effects of metformin but it could be inducing a caspase-independent cell death in co-treated cells. Although in-silico analysis suggested potential molecular targets and interconnected mechanisms, lower concentrations did not alter PI3K/Akt/mTOR gene expression.

Objective: To compare the effectiveness of pixel CO2 laser and vaginal promestriene in treating genitourinary syndrome of menopause (GSM). Methods: A quasi-randomized controlled trial was conducted with 48 patients. CO2 Laser Group (24 patients) received 3 sessions of vaginal pixel CO2 laser, and promestriene group (24 patients) used vaginal promestriene daily for 14 days, then twice weekly for 3 months and 3 weeks. Patients were evaluated before and after treatment using a visual analog scale (VAS), FSFI-6, ICIQ-SF, Vaginal Health Index (VHI), and vaginal wall biopsy. Results: Of the 48 patients, 22 in CO2 Laser Group and 21 in promestriene group completed the study. Both groups showed significant symptom reduction by VAS, with improvements in desire, lubrication, and total FSFI-6 scores. CO2 Laser Group had greater improvements in lubrication, orgasm, and satisfaction (p<0.001). Urinary incontinence improved in both groups (p<0.01). VHI scores increased significantly in both groups (p<0.001). Biopsies revealed improvements in collagen, glycogen, vascularity, epithelial thickness, and reduced neutrophil count (p<0.01). Conclusion: CO2 laser appears to be a viable non-hormonal alternative for treating GSM, particularly for women unable or unwilling to use hormonal therapies.

Obesity and type II diabetes are independent risk factors for Endometrial cancer (EC) development. Elevated levels of insulin-like growth factor-1 (IGF-1), insulin resistance, and the increased activity of IGF-1 receptor is linked to EC development through the PI3K/AKT/mTOR pathway. The antidiabetic agent metformin is a promising repurposing drug for cancer treatment, but the mechanisms underlying its effects are not completely known. This study evaluated how metformin could act against the EC cell line Ishikawa cultured in vitro or grafted into female Balb/C nude mice. In vitro experiments demonstrated that treatment with 25 mM of metformin reduced cell viability through promoting cytotoxicity, mitochondrial dysfunction, apoptosis, and cell cycle arrest (G1 phase). Mice treatment with 250 mg/kg of metformin for 28 days did not change serum IGF-1 levels nor decreased the grafted cell-induced tumor weight and cell proliferation, but prevented its volume growth while genes of the IGF1-R and PI3K/AKT/mTOR pathways (AKT2, GAPDH, FOXO3, IGF1R, INSR, MAPK3, MTOR, and SHC1) were downregulated. Metformin treatment was more impacting for the in vitro model, but our molecular results provide valuable insights into the possible action of metformin against EC tumoral cells at physiological level. In-silico analysis using Cytoscape indicated that metformin was not described as interacting with AKT2 and SHC1 proteins. Besides interacting with metformin, mTOR and MAPK3 present the larger number of interactions with the other proteins. These four genes/proteins emerge as potential targets for deepening studies to determine the metformin's role in longer EC treatment using animal models.

Objetivo: Este estudo teve como objetivo avaliar os efeitos de diferentes técnicas de seleção espermática sobre parâmetros seminais e características estruturais utilizando citometria de fluxo, com foco na viabilidade celular, produção de espécies reativas de oxigênio (ROS) e integridade acrossômica.Métodos: Amostras de sêmen de oito voluntários normospérmicos foram submetidas a duas técnicas de seleção espermática: lavagem simples e centrifugação em gradiente de densidade. Após o processamento, as amostras foram analisadas por citometria de fluxo para avaliar motilidade, viabilidade, produção de ROS, peroxidação lipídica, reação acrossômica e estabilidade da membrana plasmática.Resultados: O método de gradiente de densidade aumentou significativamente a motilidade total (70,75% ± 12,87%) em comparação tanto com o sêmen in natura (55,63% ± 8,55%) quanto com a técnica de lavagem (53,13% ± 4,61%). Além disso, a porcentagem de espermatozoides vivos foi maior no grupo de gradiente de densidade (71,63% ± 13,72%) do que no grupo lavado (54,50% ± 9,53%). Não houve diferença significativa na produção de ROS entre as técnicas; entretanto, a técnica de gradiente de densidade reduziu o número de células mortas produtoras de ROS (0,04% ± 0,06%) em comparação com a técnica de lavagem (0,13% ± 0,23%). Observou-se aumento no número de células com acrossomo reagido após a centrifugação em gradiente de densidade (25,79% ± 15,07%) em comparação com o sêmen in natura (8,80% ± 4,28%).Conclusão: A centrifugação em gradiente de densidade é superior à técnica de lavagem na seleção de espermatozoides viáveis e móveis: melhorou significativamente a motilidade total e a viabilidade. Embora a técnica de gradiente de densidade não tenha aumentado o estresse oxidativo, ela esteve associada a maior incidência de reação acrossômica, o que pode ter implicações nos resultados de fertilidade.

Abstract:To improve clinical outcomes of human medically assisted reproduction, the transfer of multiple embryos is frequently performed. This leads to high rates of multiple pregnancies. In this study we explored if a cohort of patients can be defined, that benefits from the transfer of two embryos while mitigating the odds of multiple pregnancies by considering female patients' age, embryo quality and embryo cohort quality. In this retrospective cohort study, clinical pregnancy rate (CPR), live birth rate (LBR) and multiple pregnancy rate (MPR) after fresh single embryo transfers (SETs, n = 245) were compared to those after double embryo transfer (DET, n = 278). Female patient's age, embryo quality and embryo cohort quality were used to explore clinical outcomes in subgroups. Overall, this study found that compared to SET, DET significantly increased the CPR (33.5 vs 49.6%, adjusted odds ratio (aOR): 2.233, 95% CI: 1.529-3.261, P < 0.001), LBR (24.1 vs 39.2%, aOR: 2.416, 1.605-3.636, P < 0.001) and MPR (0.0 vs 25.4%, P < 0.001). Subgroup analysis based on female age, embryo quality and further stratification based on embryo cohort score revealed that the MPR in all subgroups was high after DET and a subgroup with significantly reduced MPR after DET could not be defined. In conclusion, DETs are associated with high MPRs that cannot be avoided by considering female patients' age, embryo quality and embryo cohort quality. SET is the most effective way to avoid a multiple pregnancy. Lay summary:This study examined whether it is possible to avoid multiple pregnancies in treatments of assisted reproduction when two embryos are transferred to certain patients. Transferring more than one embryo can increase the chances of pregnancy and live birth but also raises the risk of multiple pregnancies. Multiple pregnancies are linked to health risks for both the mother and the children. Using data from a single clinic, this study explored whether there are specific patients who could benefit from the transfer of two embryos while still having a lower risk of multiple pregnancy. However, the researchers found that DETs consistently lead to high rates of multiple pregnancies, even when factors like the mother's age, embryo quality and overall embryo cohort quality are considered. The researchers concluded that transferring a single embryo remains the safest approach to prevent multiple pregnancies.

OBJECTIVE:To evaluate whether ovulation triggers improve pregnancy and/or ovulation rates in women with unexplained or anovulatory infertility undergoing ovulation induction and natural intercourse or intrauterine insemination (IUI), without increasing complications. METHODS:We searched nine databases and grey literature from inception to August 29, 2023. Parallel-group randomized controlled trials (RCTs) including women with unexplained or anovulatory infertility undergoing ovulation induction and natural intercourse or IUI, comparing ovulation trigger versus placebo or no treatment, were included. Outcomes included pregnancy, ovulation, and complications. Risk of bias was assessed using the RoB 2 tool, and GRADE was applied for certainty of evidence. The Hartung-Knapp random-effects model was used to calculate odds ratio (ORs) (α=0.05). R packages "metafor", "meta", and "metasens" were used. RESULTS:Six studies (1,218 women) were included; all studies used hCG as the trigger. For clinical pregnancy (n=855, 4 studies), OR=1.23 (95% CI: 0.91-1.66); for live birth (n=45, 2 studies), OR=0.92 (95% CI: 0.14-6.02); for miscarriage (n=89, 3 studies), OR=0.68 (95% CI: 0.20-2.35); for ovulation (n=311, 2 studies), OR=1.70 (95% CI: 0.84-3.43); and for multiple pregnancy (n=523, 2 studies), OR=2.56 (95% CI: 0.43-15.11). No subgroup analysis altered certainty of evidence and risk of bias was low. CONCLUSIONS:Current evidence is insufficient to recommend or refute ovulation triggers. hCG may increase ovulation, but effects on pregnancy outcomes remain uncertain.

INTRODUCTION AND HYPOTHESIS:The onset of symptoms associated with pelvic floor dysfunctions and injuries after pregnancy and childbirth has been well documented and studied. Avulsion of the levator ani muscle (LAM) is known to be a risk factor for these conditions. This study aimed to evaluate the prevalence of LAM avulsion in patients after their first vaginal delivery, associating this finding with factors related to pregnancy and birth. MATERIALS AND METHODS:In a cross-sectional study, we evaluated 100 postpartum women after their first vaginal delivery to identify LAM avulsion using ultrasound imaging and to correlate the presence of this injury with pregnancy and birth-related factors. RESULTS:Of the 100 primiparous women evaluated, 46% had some degree of avulsion after delivery. Among these, 37% had complete and 63% had partial avulsion. Regarding laterality, 63% of the lesions were unilateral, affecting the muscle asymmetrically, and 37% were bilateral. The weight of the newborn was a significant factor and showed a statistically significant difference between the groups with and without avulsion. Another statistically significant difference observed between the groups was forceps delivery. CONCLUSIONS:The impact of pregnancy and childbirth factors on the pelvic floor muscles is not yet fully elucidated. Identifying these factors is crucial for developing multidisciplinary strategies to prevent such injuries during pregnancy and delivery, thereby reducing their consequences and impact on women's quality of life.

Objective:Advanced maternal age has become more common due to factors such as increased academic preparation for women, labor market participation, delayed family planning, and advances in reproductive medicine. This phenomenon raises questions about the risks and gestational outcomes associated with advanced maternal age (AMA). This study aims to explore the gestational and perinatal outcomes in pregnant women with AMA (> 35 years), comparing them with those of women aged 20 to 34 years. Methods:The research was conducted as an observational and retrospective analysis, examining data from 2012 to 2022 from the Hospital Production System (SIH/SUS) available on the DATAsus platform, covering all regions of Brazil. Variables analyzed included gestational duration, type of pregnancy (single or multiple), mode of delivery, Robson group, APGAR score at five minutes, birth weight, and occurrence of congenital anomalies. Results:Pregnant women with AMA showed statistically significant differences in the higher percentage of cesarean sections (63.3% AMA vs 58% non-AMA, p<0.05), higher percentage of low birth weight newborns (12.5% AMA vs 6.7% non-AMA, p<0.05), lower APGAR scores at the fifth minute (OR = 1.08, p<0.001) and a higher prevalence of any congenital anomalies (1.23% AMA vs 0.77% non-AMA, OR =OR = 1.34, p < 0.001). In addition, this group had a higher incidence of premature births (12.99% AMA vs 8.78% non-AMA) and multiple pregnancies (1.39% AMA vs 0.83% non-AMA). Furthermore, in the Robson classification, there was a predominance of older mothers in Group 5 (previous cesarean section) and in the groups with nulliparity. Conclusion:Pregnant women with AMA face higher gestational and perinatal risks, such as preterm births and an increased need for cesarean sections. These findings underscore the importance of public policies and personalized management strategies to improve maternal and neonatal outcomes for older pregnant women.

BACKGROUND:Seminal cryopreservation causes significant sperm damage, prompting research into alternative preservation methods. This study aimed to compare the effects of washing and density gradient processing-both involving seminal plasma removal-on oxidative damage, acrosomal, and mitochondrial integrity. MATERIALS AND METHODS:Seminal samples from 26 normozoospermic patients were divided into three parts: one containing seminal plasma, the second processed by washing, and the third processed by selection through a density gradient. The samples were cryopreserved for at least 2 weeks. reactive oxygen species (ROS) production (measured using the DCF probe), plasma membrane peroxidation (BODIPY probe), acrosome integrity (fluorescein isothiocyanate-labeled/prostate-specific antigen [FITC/PSA] probe), lipid disorder (merocyanine 540 probe), and mitochondrial potential (JC1 probe) were evaluated through flow cytometry before cryopreservation and after thawing. RESULTS:Density gradient processing reduced ROS production compared to washing (p < 0.05). No increase in the ROS production was observed after thawing. In the fresh condition, both density gradient and washed samples showed a lower proportion of oxidized cells compared to raw samples (p < 0.001). Acrosomal damage was significantly higher in washed samples compared to other groups in fresh samples (p < 0.001). Cryopreservation caused acrosomal damage only in raw samples (p < 0.001), with gradient samples maintaining greater acrosomal integrity after thawing. Plasma membrane instability was lower in the gradient of the fresh group compared to raw or washed samples (p < 0.001). Cryopreservation induced plasma membrane destabilization in processed samples but not in samples frozen with seminal plasma. After thawing, plasma membrane destabilization was lower in the gradient group compared to raw and washed samples (p < 0.05 and p < 0.001). Cells in the gradient group showed higher mitochondrial potential (p < 0.001), followed by washed samples compared to raw samples (p < 0.01). Mitochondrial membrane potential was significantly impaired in all three processes, with no differences among the groups after thawing. CONCLUSION:Cryopreservation significantly damages the acrosome and mitochondria of spermatozoa. In normozoospermic patients, the gradient method selected higher-quality spermatozoa compared to other processes, preserving functional advantages after thawing.

Objective:Seminal cryopreservation causes significant damage to the sperm; therefore, different methods of cryopreservation have been studied. The aim of the study was to compare the effects of density gradient processing and washing/centrifugation with seminal plasma removal for cryopreservation in semen parameters.Methods:Seminal samples of 26 normozoospermic patients were divided into 3 parts: with seminal plasma; after washing/centrifugation; and after selection through density gradient. The samples were cryopreserved for at least two weeks. Motility, sperm count, morphology and viability were evaluated before cryopreservation and after thawing.Results:Density gradient processing selected motile and viable sperm with normal morphology in fresh samples (p<0.05). Cryopreservation negatively affected all sperm parameters regardless of the processing performed, and even if the sperm recovery was lower in the density gradient after the thawing, progressive motility, total motility, viability and morphology remained higher (p<0.05).Conclusion:Cryopreservation significantly compromises sperm parameters (motility, morphology, viability). In normozoospermic patients, the density gradients select better quality spermatozoa compared to other processing methods; this benefit was kept after thawing.

INTRODUCTION:Suicide is a worldwide health concern and up to date there is no good predictor of it except a previous suicide attempt. Therefore, there are increasing efforts in the understanding of which factors, genetic or environmental, are associated with suicide behaviour.OBJECTIVE:To review evidence of the effect of childhood trauma and impulsivity on suicidal behavior through a systematic review and meta-analysis.METHODS:Searches were conducted on the 12th of June 2021 in the PubMed, Scopus, and Web of Science databases. Two reviewers evaluated each record for eligibility and discussed upon disagreement, when no consensus was reached, a third reviewer was involved to make a decision.RESULTS:A total of 11,530 records were identified through the searches. After duplicates were removed, 6,595 records remained to be screened. The full text was sought for 1,561 records. Our qualitative synthesis included 22 studies, from which 9 were included in the meta-analyses. We found a significant effect of sexual abuse, physical abuse, emotional abuse and physical neglect on suicide attempts in the prisoners, and Substance Use Diorder (SUD) subgroups. Moreover, there was a significant effect of Childhood Trauma Questionnaire (CTQ) total score and emotional neglect dimension for all the subgroups.CONCLUSION:The present study has provided an overview of the state-of-the-art research on childhood trauma and impulsivity and their association with suicidal behavior and quantified their effects on suicide attempts. Hopefully this evidence will be considered in future research and harnessed for clinical gain in detection and treatment of suicide behaviour.

OBJECTIVE:The Mini International Neuropsychiatric Interview (MINI) is one of the most used instruments for the assessment of Mental Disorders, playing an essential role in psychiatric research and in clinical and hospital practice. Despite this, the accuracy of the MINI, when used by a psychiatrist, is poorly studied, particularly in relation to Bipolar Disorder (BD). The early diagnosis of BD and Major Depressive Disorder (MDD) is extremely important, as it provides an opportunity for intervention that can reduce the impact on the patient's daily life and functionality. As such, this study assesses the suitability of MINI for diagnosing BD or MDD in a sample of patients with mood disorders.METHOD:Agreement between the MINI and the clinical interview was assessed in a sample of 347 outpatients by calculating Cohen's kappa, sensitivity, specificity, positive predictive value, negative predictive value, and the area under the curve (AUC).RESULTS:The sample consisted of 347 patients with mood disorders. 279 were women (80.40%), 105 (30.3%) were diagnosed with MDD and 242 (69.7%) with BD from the assessment performed in the clinical interview. In the MINI assessment, 97 individuals (28%) were classified with a diagnosis of MDD and 250 (72%) with BD. We found a sensitivity of 87.2% and specificity of 62.8% for the MINI in the diagnosis of BD and a Cohen's kappa between the MINI and the clinical interview of 0.51. The AUC was 0.75.CONCLUSIONS:MINI has greater sensitivity (87.2%) for the diagnosis of BD and greater specificity (87.2%) for the diagnosis of MDD. In addition, the moderate Cohen kappa (0.51) and AUC (0.75) values between the MINI and the clinical interview are acceptable when considering most available psychiatric diagnostic tools.

Objective:Evaluate histological changes in testicular parameters after hormone treatment in transgender women. Methods:Cross-section study with patients who underwent gonadectomy at Hospital de Clínicas de Porto Alegre from 2011 to 2019. Hormone treatment type, route of administration, age at initiation and duration were recorded. Atrophy parameters were observed: testicular volume, tubular diameter, basal membrane length, presence of spermatogonia and spermatids (diploid and haploid spermatozoid precursors). Results:Eighty-six patients were included. Duration of hormone treatment is associated with testicular atrophy and spermatogenesis arrest. Other characteristics of hormone treatment such as age of initiation, route of administration and type of treatment were not associated with testicular histological changes. Testicular volume may predict spermatogenesis arrest. Basal membrane length and tubular diameter ratio is an interesting predictor of germ cell presence. Conclusion:Cross-sex hormone treatment affects testicular germ cell presence. Basal membrane length and tubular diameter ratio reduces inter variability of measurements and better exemplify how atrophic seminiferous tubules are. Fertility preservation should be addressed by healthcare providers in order to recognize gender affirming treatment impact on transgender health.

BACKGROUND:Pregnancy involves anatomical, physiological, and metabolic changes in a woman's body. However, the effects of these changes on the voice remains unclear, particularly regarding the clinical characteristics. OBJECTIVES:We aimed to evaluate changes in vocal and speech acoustic measures and the relationship between them and clinical aspects in women during pregnancy. METHOD:A prospective, longitudinal study was carried out with 41 low risk, adult, pregnant women, followed for prenatal care. Demographic and anthropometric data as well as lifestyle habits and health conditions were collected. Voice recordings of sustained vowels, and automatic and spontaneous speech were held over each trimester and analyzed by PRAAT®to evaluate acoustic, aerodynamic, and articulatory measures. RESULTS:There were no changes in fundamental frequency, jitter, shimmer, and harmony to noise ratio during pregnancy. Maximum phonation time (MPT), pause rate, and pause duration reduced at the end of pregnancy. MPT was lower in sedentary pregnant women. The fundamental frequency peak rate was higher in eutrophic participants and lower in the third trimester in women with BMI ≥25 kg/m2. Pause rate was higher in pregnant women with BMI ≥25 kg/m2. There was no relationship between sleep quality, reflux, and vocal symptoms and acoustic and aerodynamic measures. CONCLUSIONS:Differences were shown in MPT and temporal pause measurements during pregnancy. Acoustic measurements did not change. There was a relationship between acoustic and aerodynamic measures and clinical variables (BMI, physical activity, and body mass gain).

To analyze the factors (socio-demographic, clinical, prenatal care, delivery, postpartum data and anthropometric measures) associated with the birth of small for gestational age newborns.

Purpose Evaluate histological changes in testicular parameters after hormone treatment in transgender women. Materials and Methods Cross-section study with 86 patients who underwent gonadectomy. Hormone treatment type, route of administration, age at initiation and duration were recorded. Atrophy parameters were observed: testicular volume, tubular diameter, basal membrane length, presence of spermatogonia and spermatids (diploid and haploid spermatozoid precursors). Results Duration of hormone treatment determines testicular atrophy and spermatogenesis arrest. Other characteristics of hormone treatment such as age of initiation, route of administration and type of treatment were not associated with testicular histological changes. Testicular volume may predict spermatogenesis arrest. Basal membrane length and tubular diameter ratio is an interesting predictor of germ cell presence. Conclusion Basal membrane length and tubular diameter ratio reduces inter variability of measurements and better exemplify how atrophic seminiferous tubules are. Fertility preservation should be addressed by healthcare providers in order to recognize gender affirming treatment impact on transgender health.

INTRODUCTION:The handling of antineoplastic drugs should follow strict supervision and safety rules to minimize the occupational exposure risks to professionals involved. The external surface contamination of drug vials is recognized as a health risk. So, our goal was to determine if there is residual contamination on the vials and containers surface of the antineoplastic drugs doxorubicin (DOX) and cyclophosphamide (CP).METHODS:A cross-sectional study was conducted. Samples were collected using a uniform sampling procedure on the inner surfaces of the packages/boxes and the outer surfaces of the vials. The analyzes were executed by high-performance liquid chromatography/mass spectrometry (UHPLC-MS/MS).RESULTS:A total of 209 samples were analyzed, 66 of CP and 143 of DOX. CP levels were detected in nine samples (13.63%), three were below the lower limit of quantification (LLQ) and the other six had contamination levels ranging from 1.24 to 28.04 ng/filter. DOX levels were detected in 36 samples (25.17%), two were below the LLQ and the others had levels between 1.32 and 664.84 ng/filter. The majority of samples with residual contamination were in vials (80.0%), however, boxes also showed contamination.CONCLUSIONS:The results revealed the presence of residual contamination in the vials and packages of CP and DOX drugs. Although the residues found in each sample are small, special care should be taken in the handling and disposal of the antineoplastic drugs. The use of personal protective equipment is fundamental while handling the vials and packaging of cytotoxic drugs.

Objective To evaluate the reproductive and histological characteristics of fresh cultured ovarian tissue from transgender male patients. Methods An in vitro pilot study in which samples were collected during sex reassignment surgery for transgender male patients. The ovarian cortex was cut into fragments of 2 mm, 3 mm, and 4 mm, and placed in a 96-well plate suitable for cultivation at days 0, 2, 4, 6, and 8, when the histology was analyzed. Results Stromal hyperplasia was observed in all samples, and it was not associated with the obtainment of primordial or primary follicles. Peripheral reduction in cell count was also a recurrent finding. Primordial and primary follicles were identified with a heterogeneous pattern in fragments from the same patient and from different patients, and follicles in more advanced stages of development (secondary and antral) were not found. There was an association between the diameter of the ovarian fragments and the identification of primary follicles ( p = 0.036). The number of days in culture was associated with histological signs of tissue damaging in the fragments ( p = 0.002). The total number of follicles identified in the samples with 2 mm in diameter was significantly lower than in those that measured 4 mm in diameter ( p = 0.031). Conclusion A diameter of 4 mm is suitable for ovarian tissue culture with the benefit of ease of handling. Even after prolonged exposure to testosterone, the ovarian fragments presented primordial and primary follicles, maintaining viability throughout the days they were exposed to the culture. Freezing the ovarian cortex of transgender patients who will undergo surgery for gender reassignment would be an interesting option, in the future, for the preservation of fertility.

Zielsetzung While the number of untransferred embryos is positively correlated with the implantation potential, this study aimed to clarify to what extend the quality of the cultivated embryo cohort score (ECS) influences the pregnancy success rates.